Global Fund New Funding Model and TB Strategic Investment Framework

1. Global Fund New Funding Model and TB Strategic Investment Framework Regional Workshop on NSP for TB Control Chisinau, Moldova, 8thOct. 2012

2. Outline • The GF new funding model • Strategic Investment Framework - Objectives and Scope • Tools to support Strategic investment • TB Strategic Investment Framework • Potential uses of Strategic Investment Framework

7. Strategic Investment Framework Objective Gives guidance on interventions representing a good investment Relates to specific country settings / epidemiology Scope Overall country response (not just Global Fund investments) Does not substitute for contextual guidelines and country dialogue Partner input in developing the tool Developed by technical partners Global Fund has coordination role

8. Four tools support strategic investment Provide quality estimates of demand, programmatic and financial gaps Demand forecasts Inform the development of requests through common guidance Investment framework Focus of this session Unit cost benchmarks Provide costing guidance Built into framework when ready Portfolio analysis Allow monitoring and optimization of investments

9. Why apply an investment framework? High MDR-TB country: limited funds to share between DOTS / MDR-TB • Phase 1: DOTS strategy only • Phase 2: Reprogramming to MDR-TB, covering only 300 cases1 • Challenge under limited funding: share of funding between DOTS and MDR-TB Caveats: other donor spending not accounted for and differing costs by interventions. Definitional / data challenges. 1. Less than 15% of total MDR-TB cases in the country Source: Global Fund

10. TB Strategic Investment Framework Work conducted with WHO, STOP TB Partnership, the Union, BMGF, RESULTS USA, USAID, TBCARE, KNCV, TRP, ...

11. TB SIF in line with national strategies Assessment TB epidemiological assessment: “Know your epidemic” Health system assessment National TB Program assessment: results to date, resource mapping, GF grant performance / outcomes Gaps in implementation and financial resources Define overall country “type” Design appropriate packages of care and critical enablers Roles and responsibilities: Government, private, non-governmental and civil society partners Budgeting & financial planning Package design, roles, and financing

12. TB investment framework components CORE PACKAGES • Based on • Stop TB Strategy • Global Plan to Stop TB 2011-2015 • Draft post-2015 TB strategy framework Health/Development Synergies High Risk Group Interventions * TB/HIV package -- To be costed/funded under TB and HIV programmes (eg, included Treatment/care & support package of HIV investment framework

13. Country types and associated interventions Core packages • Relative shares or indicative ranges of investment • Basic packages with enablers • High-risk group interventions • Synergies • Determined at national level • Country assessments • Available funding from other sources • Unit cost benchmarks DOTS-based package + TB/HIV package for high risk groups Endemic countries + MDR-TB package for high-risk groups High and medium TB burden settings + Critical enablers + Other High-risk group interventions + Synergies DOTS-based package + MDR-TB package for high-risk groups High TB/HIV countries1 + Critical enablers + Other High-risk group interventions + Synergies + TB/HIV package Country type (mutually exclusive) DOTS-based package + TB/HIV package for high risk groups High MDR-TB countries2 + Critical enablers + Other High-risk group interventions + Synergies + MDR-TB package DOTS-based package incl. enablers Countries with high TB/HIV and high MDR-TB + TB/HIV package + MDR-TB package + Other High-risk group interventions + Synergies 1. > 5% HIV in TB, or >1% in general population; 2. As defined by WHO – high rate and absolute burden countries

14. TB interventions

15. TB interventions

16. Application process in the new funding model NOT THE FULL VISION OF THE NEW FUNDING MODEL TRP review Board approval Recommend in indicative range National Strategic Plan1 Country Dialogue Concept Note (prioritized full demand) Grant-making Potential TRP review Recommend above indicative range Guidance package Indicative funding range Secretariat Info / Analysis Incentive stream Recommended for funding by incentive pool or as resources available Unfunded queued demand Minimum Standards SIFs and tools 1. Where a robust National Strategy or NSP is available

17. Potential uses of SIF in the Global Fund process Process stage Potential use • In line with robust NSP • NSP process 1 • Concept note • Influence funding requests • Inform dialogue1 2 • Independent technical review 3 • Potential cross-check for strategic investment • Grant-making 4 • Renewals and Reprogramming • Guide Secretariat and potentially TRP recommendations 5 Note: Exact use of framework will be depend on its final content 1. As part of the guidance package including indicative funding levels, Secretariat information / analysis, minimum standards, investment framework